CT and MR Arthrography of the Normal and Pathologic Anterosuperior Labrum and Labral-Bicipital Complex

Abstract

Interpretation of computed tomographic and magnetic resonance arthrograms of the shoulder is complicated by normal variants of the labrum and glenohumeral ligaments. A superior sublabral recess is located at the 12 o'clock position and represents a normal recess between the superior labrum and the cartilage of the glenoid cavity. A sublabral foramen is located at the 2 o'clock position and represents localized detachment of the labrum from the glenoid rim. Buford complex is characterized by absence of the anterosuperior labrum and cordlike thickening of the middle glenohumeral ligament. Imaging features of damage to the anterior labrum include absence or detachment of the labrum and an irregular frayed appearance. Superior labrum anterior-to-posterior (SLAP) lesions are classified as type I (tear confined to the superior labrum), type II (labrum and biceps tendon detached from the superior glenoid), type III (bucket handle tear of the superior labrum), or type IV (bucket handle tear of the superior labrum with lateral extension into the biceps tendon). Increased distance between the labrum and the glenoid, an irregular appearance of the labral margin, or lateral extension of the separation may suggest a SLAP lesion rather than a normal anatomic variant. However, differentiation between normal variants and pathologic conditions and between various types of SLAP lesions remains difficult.

Cartilage lesions of the glenohumeral joint: diagnostic effectiveness of multidetector spiral CT arthrography and comparison with arthroscopy

“…The vast majority of imaging studies dedicated to the shoulder have focused on the use of MR imaging, CT arthrography or MR arthrography (MRa) to analyze lesions of the rotator cuff and of the glenoid labrum [1][2][3][4][19][20][21][22]. In contrast to this fibrocartilage, the hyaline cartilage of the shoulder has barely been studied by modern imaging techniques.…”

Type II SLAP lesions: A new scoring system— the sulcus score

“…We arthroscopically examined the superior labral sulcus using a probe, the tip of which was 2 mm, because a quantitative assessment of the superior labral sulcus is difficult with magnetic resonance imaging or magnetic resonance arthrography. 5,13,14 Pfahler et al 11 showed the age-related changes of the superior labrum in normal shoulders. Histopathologically, the labrum showed a significant qualitative and quantitative increase in superior labrum lesions with increasing age.…”

Shoulder pain in primary care: frozen shoulder

“…[8][9][10][11] The prevalence of asymptomatic rotator cuff tears is reported to increase from ~20% to 50% in people aged over 60 years, 9,12 and may be more than 50% in people aged over 80 years. 9,13 Subacromial bursal pathology, and evidence of bursal bunching on ultrasound are also common findings in patients with shoulder pain, reported respectively in 31% and 42% of patients with a variety of shoulder conditions in primary care.…”